tbuckley/cabot-search huggingface dataset:
Long-term efficacy of a modified non-flared fully covered metal stent for benign main pancreatic duct strictures: results of a 6-year follow-up study
Authors: J. H. Myeong, J. H. Moon, Y. N. Lee, I. S. Shin, J. K. Yang, T. H. Lee, S. W. Cha, Y. D. Cho, S. H. Park
Journal: Endoscopy (2023)

Aims Despite fully covered self-expandable metal stents (FCSEMSs) can be effective for the treatment of main pancreatic duct (MPD) strictures associated with chronic pancreatitis, relevant long-term results are rarely reported. We evaluated the long-term efficacy of the modified non-flared FCSEMS (M-FCSEMS) in patients with benign MPD strictures due to chronic pancreatitis.
Validation of a Novel CADe Algorithm for Detection of Neoplasia in IBD: Data from Image Based and Real-time Studies
Authors: K. Siggens, H. Htet, Y. Iwadate, S. Namiki, A. Al-Kandari, M. Abdelrahim, P. Bhandari
Journal: Endoscopy (2023)

Aims Patients with inflammatory bowel disease (IBD) have a higher risk of colorectal cancer. However, neoplasia in IBD is subtle and difficult to detect. Computer Aided Detection (CADe) is becoming increasingly used for polyp detection in standard colonoscopy, but its use has so far been restricted to non-colitic bowel. Here we describe a novel IBD CADe algorithm.
Comparison of ESD and EMR in early Barrett's neoplasia
Authors: M. A. Noreillie, D. De Wulf, R. Bisschops
Journal: Endoscopy (2023)

Aims Current guidelines support endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) as first-line treatment in superficial Barrett's neoplasia. We compared lesion characteristics, adverse events, clinical outcomes and recurrence between both techniques.
Risk factors of recurrence after surgical and endoscopic resection of T1 rectal cancer
Authors: H. Thorlacius, C. F. Rönnow, E. Nilsson
Journal: Endoscopy (2023)

Aims Optimal treatment of T1 rectal cancer remains to be determined. The aim of this investigation was to determine risk factors related to recurrence after surgical and local resection of T1 rectal cancer in a large nationwide cohort.
Experience with endoluminal vacuum therapy for the management of upper gastrointestinal tract defects in a tertiary hospital
Authors: A. Baines garcía, C. Ramos Belinchón, M. Cova Chinea, D. Hernández Castillo, Ó. Nogales Rincón, H. J. Aranda, B. Merino Rodríguez, J. García Lledó
Journal: Endoscopy (2023)

Aims Upper gastrointestinal tract leaks, fistulae, and perforations often represent a management challenge. Endoluminal vacuum therapy (E-VAC) is a new treatment which is still under investigation. The aim of this study is to describe the clinical course of patients treated with this technique in our center and to analyze which factors were associated with its success.
Role of a novel peptide-based haemostatic agent in early gastrointestinal bleeding management: why not expand the current toolbox?
Authors: R. Ballester-Clau, C. Costigan, A. M. O´sullivan, F. O´hara, S. Sengupta, D. McNamara
Journal: Endoscopy (2023)

Aims To assess the efficacy, feasibility and safety of a novel peptide-based hemostatic agent (PBHA), in a selected cohort with gastrointestinal bleeding [1] [2] [3] [4] [5] [6] [7].
Safety and efficacy of salvage endoscopic submucosal dissection for Barrett’s neoplasia recurrence after radiofrequency ablation
Authors: L. Mesureur, P. H. Deprez, R. Bisschops, R. Pouw, B. Weusten, M. Barret, P. Dewint, D. J. Tate, P. Leclercq, S. Seewald, F. Barbaro, F. Baldaque-Silva, M. Omae, M. Pioche, M. J. Bourke, R. Haidry, A. Lemmers
Journal: Endoscopy (2023)

Aims We aimed to review the safety and efficacy of salvage ESD for Barrett's neoplasia recurrence after radiofrequency ablation (RFA).
Risk factors for late post-procedural bleeding after endoscopic resection of large colorectal lesions: a multicenter retrospective study
Authors: S. Belle, Q. Xiao, M. Ebert, M. Eckardt, A. Mohamed, H. Ernst, A. Behrens, N. Homann, G. Kähler, T. Zhan
Journal: Endoscopy (2023)

Aims Post-procedural bleeding is a major adverse event after endoscopic resection of large colorectal lesions. Late post-procedural bleeding is challenging as it frequently occurs after discharge of patients. Here, we aimed to identify clinical risk factors for late bleeding for adapted management of these patients.
Deep Learning And Capsule Endoscopy: Panendoscopic Classification Of Small Bowel And Colon Preparation Using A Convolutional Neural Network
Authors: J. P. Afonso, T. Ribeiro, P. Marílio Cardoso, M. Mascarenhas, P. Andrade, J. Ferreira, C. Hélder, M. Guilherme
Journal: Endoscopy (2023)

Aims Colon capsule endoscopy (CE) allows minimally invasive inspection of the small bowel and colonic mucosa. An adequate bowel preparation is crucial for conclusive CE exams. Different scales have been applied for the evaluation of bowel preparation in CE videos, however their application is time-consuming and have a high interobserver variability. To date, no AI-based model has been developed for automatic evaluation of small bowel and colon preparation in CE exams.
Long term efficacy of the endoscopic transoral outlet reduction for dumping syndrome and weight regain after roux-en-y gastric bypass
Authors: V. Pontecorvi, M. V. Matteo, B. Vincenzo, M. De Siena, C. Giorgio, P. Giulia, L. Vinti, G. Costamagna, C. Spada, I. Boskoski
Journal: Endoscopy (2023)

Aims To assess the safety and long-term efficacy of endoscopic transoral outlet reduction (TORe) as a treatment for DS and/or weight regain after Roux-n-Y gastric bypass (RYGB).
SNAP Procedure. Duodenal-Ileal Diversion with Self-Assembling Magnets in Patients with Inadequate Weight Loss or Weight Regain following Sleeve Gastrectomy: Feasibility and Six-Month Results
Authors: R. Turro, A. Diez-Caballero, A. Ortega Sabater, A. Mata, S. Feliz, A. Vila Moix, H. Uchima, J. Saez Hernandez, R. Temiño López-Jurado, J. Michelena, M. Rosinach, H. Vergara Badia, S. Andrés Valero, S. Ruiz, J. Espinós
Journal: Endoscopy (2023)

Aims A study to determine the technical feasibility and safety of a minimally invasive, duodenal-ileal side-to-side anastomosis using a Sutureless Neodymium Anastomosis Procedure (SNAP) for patients with weight-regain or inadequate weight-loss following SG.
Indeterminate biliary strictures in the era of cholangioscopy: comparison of the diagnostic techniques in a tertiary referral center
Authors: M. Gesualdo, M. Sacco, F. Castellano, E. Dall'Amico, M. T. Staiano, A. Mauriello, F. Fimiano, S. Caronna, C. G. De Angelis
Journal: Endoscopy (2023)

Aims Biliary strictures remain often indeterminate (IBS) after the basic work up, due to the poor diagnostic yield of radiological imaging and low sensitivity of standard ERCP/EUS. In the last years the growth of digital single-operator cholangioscopy (DSOC) with guided-biopsies (DSOC-GB) and other techniques, such as confocal laser endomicroscopy probe-based (pCLE) and intraductal ultrasound (IDUS), is driving mutation in this scenario. Aim of our study is to compare DSOC, IDUS and pCLE with cytology and DSOC-GB in patients with IBS.
Successful Management of Occluded Hepaticojejunostomy Anastomotic Stricture and Multiple Intrahepatic Duct Stones, in a Patient with Prior Failed Radiological Treatment, Using a Combination of Transhepatic Cholangioscopy and Enteroscopy
Authors: S. M. Hassan, M. Hussain
Journal: Endoscopy (2023)

Aims We are reporting an innovative approach using a combination of transhepatic cholangioscopy and enteroscopy to successfully manage hepaticojejunostomy anastomotic stricture (HJAS) iasociated with multiple intrahepatic duct stones (IHDS).
Sex differences in cancer incidence among solid organ transplant recipients
Authors: Sarah S Jackson, Ruth M Pfeiffer, Mei-Chin Hsieh, Jie Li, Margaret M Madeleine, Karen S Pawlish, Yun Zeng, Kelly J Yu, Eric A Engels
Journal: JNCI Journal of the National Cancer Institute (2023)

Abstract Background Males have 2–3-fold greater risk of cancer than females at most shared anatomic sites, possibly reflecting enhanced immune surveillance against cancer in females. We examined whether these sex differences remained among immunocompromised adults. Methods Using the Transplant Cancer Match (TCM) study, we estimated the male-to-female incidence rate ratio in TCM (M:F IRRTransplant) for 15 cancer sites diagnosed between 1995 and 2017 using Poisson regression. Male to female IRRs in the general population (M:F IRRGP) were calculated using expected cancer counts from the Surveillance, Epidemiology, and End Results Program, standardized to the transplant population on age, race and ethnicity, and diagnosis year. Male to female IRRs were compared using a chi-square test. Results Among 343 802 solid organ transplants, 211 206 (61.4%) were among men and 132 596 (38.6%) among women. An excess cancer incidence in males was seen in transplant recipients, but the sex difference was attenuated for cancers of the lip (M:F IRRTransplant: 1.81 vs M:F IRRGP: 3.96; P &amp;lt; .0001), stomach (1.51 vs 2.09; P = .002), colorectum (0.98 vs 1.43; P &amp;lt; .0001), liver (2.39 vs 3.44; P = .002), kidney (1.67 vs 2.24; P &amp;lt; .0001), bladder (2.02 vs 4.19; P &amp;lt; .0001), Kaposi sarcoma (1.79 vs 3.26; P = .0009), and non-Hodgkin lymphoma (1.34 vs 1.64; P &amp;lt; .0001). The M:F IRRTransplant was not statistically different from the M:F IRRGP for other cancer sites. Conclusions Although male solid organ transplant recipients have higher cancer incidence than female recipients, the attenuation in the male to female ratio for many cancers studied relative to the general population might suggest the importance of immunosurveillance, with some loss of advantage in female recipients due to immunosuppression after transplantation.
Trastuzumab Plus Gemcitabine-Cisplatin for Treatment-Naïve Human Epidermal Growth Factor Receptor 2–Positive Biliary Tract Adenocarcinoma: A Multicenter, Open-Label, Phase II Study (TAB)
Authors: Vikas Ostwal, Sarika Mandavkar, Prabhat Bhargava, Sujay Srinivas, Akhil Kapoor, Omshree Shetty, Sadhana Kannan, Deepali Chaugule, Rajshree Patil, Manali Parulekar, Chaitali Nashikkar, Suman Kumar Ankathi, Akshay Dwarka Baheti, Daksha Mehta, Rajiv Kumar Kaushal, Subhash Yadav, Aekta Shah, Shraddha Patkar, Mahesh Goel, Anant Ramaswamy
Journal: Journal of Clinical Oncology (2023)

PURPOSE Human epidermal growth factor receptor 2 (HER2) overexpression is seen in 4%-16% of biliary tract cancers (BTCs). We aimed to evaluate the clinical activity of gemcitabine-cisplatin (GC) plus anti-HER2 antibody trastuzumab as initial treatment in HER2-positive BTCs. METHODS This study was an investigator-initiated, open-label, single-arm, multi-institutional, phase II trial in adult patients with HER2-positive (defined as immunohistochemistry [IHC] 3+ or IHC 2+ and fluorescent in situ hybridization–positive), treatment-naïve BTCs. The primary end point of the study was 6-month progression-free survival (PFS). Next-generation sequencing was performed on tissue samples to evaluate mutational status. RESULTS From March 2020 to August 2022, of the 876 screened patients, 118 (13.4%) were found to have HER2-positive status, of whom 90 were enrolled in the study. Most patients had GBC (n = 96; 96%) with two or more sites of metastatic disease (n = 70; 78%). With a median follow-up of 17.3 (95% CI, 15.22 to 19.32) months, 72 patients had disease progression with a median PFS of 7 (95% CI, 6.2 to 7.8) months. The diagnosis to event 6-month PFS rate was 75.6% (95% CI, 66.6 to 84.6). A complete or partial response was seen in 50 (55.5%) patients and 22 (24.4%) patients had stable disease as the best response to treatment, for an overall disease control rate of 80%. The presence of isolated TP53 mutations was associated with inferior PFS compared with other mutations (TERT promoter, HER2, PIK3CA, etc) or no detected mutations (6.51 v 12.02 v 10.58 months; P &lt; .001). CONCLUSION The combination of GC and trastuzumab achieved its primary end point of improving PFS compared with historical data in the treatment-naïve HER2-positive BTC. Evaluating additional mutations such as TP53 and PIK3CA along with HER2 testing may help to preferentially select patients for anti-HER2 therapy in the future (Clinical Trial Registry India number: CTRI/2019/11/021955).
Application of Metabolomics to Epidemiologic Studies of Breast Cancer: New Perspectives for Etiology and Prevention
Authors: Mathilde His, Marc J. Gunter, Pekka Keski-Rahkonen, Sabina Rinaldi
Journal: Journal of Clinical Oncology (2023)

To provide an overview on how the application of metabolomics (high-throughput characterization of metabolites from cells, organs, tissues, or biofluids) to population-based studies may inform our understanding of breast cancer etiology.
Hospitals forced to shelve waiting list targets after Treasury refuses £1bn bailout
Authors: Gareth Iacobucci
Journal: BMJ (2023)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Hospitals forced to shelve waiting list targets after Treasury refuses £1bn bailout Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
MicroRNA-206-3p suppresses hepatic lipogenesis and cholesterol synthesis while driving cholesterol efflux
Authors: Ningning Liu, Jing Tian, Clifford J. Steer, Qinghua Han, Guisheng Song
Journal: Hepatology (2023)

Background and Aims: Hepatosteatosis, hypertriglyceridemia, and hypercholesterolemia are interconnected metabolic disorders. This study is designed to characterize how microRNA-206-3p (miR-206) simultaneously prevents de novo lipogenesis (DNL), cholesterol synthesis, and VLDL production in hepatocytes while promoting cholesterol efflux in macrophages. Approach and Results: MiR-206 levels were reduced in hepatocytes and macrophages of mice subjected to a high-fat, high-cholesterol diet. A negative feedback between LXRα (liver X receptor alpha) and miR-206 is formed to maintain high LXRα and low miR-206 in hepatocytes. Systemic administration of miR-206 alleviated hepatosteatosis, hypertriglyceridemia, and hypercholesterolemia in mice. A significant reduction in LDL cholesterol and VLDL cholesterol but unaltered HDL cholesterol was observed in miR-206-treated mice. Mirroring these findings, miR-206 reprogrammed the transcriptome of hepatocytes towards the inhibition of DNL, cholesterol synthesis, and assembly and secretion of VLDL. In macrophages, miR-206 activated the expression of genes regulating cholesterol efflux. Hepatocyte-specific expression of miR-206 reduced hepatic and circulating triglycerides and cholesterol, as well as VLDL production, while transplantation of macrophages bearing miR-206 facilitated cholesterol efflux. Mechanistically, miR-206 directly targeted Lxrα and Hmgcr in hepatocytes but facilitated expression of Lxrα in macrophages by targeting macrophage-specific tricho-rhino-phalangeal syndrome 1 (TRPS1), a transcription repressor of Lxrα . By targeting Hmgc r and Lxrα , miR-206 inhibited DNL, VLDL production, and cholesterol synthesis in hepatocytes, whereas it drove cholesterol efflux by activating the TRPS1-LXRα axis. Conclusions: MiR-206, through differentially modulating LXRα signaling in hepatocytes and macrophages, inhibits DNL, promotes cholesterol efflux, and concurrently hinders cholesterol synthesis and VLDL production. MiR-206 simulates the functions of lipid-lowering medications, statins, and LXRα agonists.
Artificial Intelligence and Machine Learning for Improving Glycemic Control in Diabetes: Best Practices, Pitfalls, and Opportunities
Authors: Peter G. Jacobs, Pau Herrero, Andrea Facchinetti, Josep Vehi, Boris Kovatchev, Marc D. Breton, Ali Cinar, Konstantina S. Nikita, Francis J. Doyle, Jorge Bondia, Tadej Battelino, Jessica R. Castle, Konstantia Zarkogianni, Rahul Narayan, Clara Mosquera-Lopez
Journal: IEEE Reviews in Biomedical Engineering (2023)

Artificial intelligence and machine learning are transforming many fields including medicine. In diabetes, robust biosensing technologies and automated insulin delivery therapies have created a substantial opportunity to improve health. While the number of manuscripts addressing the topic of applying machine learning to diabetes has grown in recent years, there has been a lack of consistency in the methods, metrics, and data used to train and evaluate these algorithms. This manuscript provides consensus guidelines for machine learning practitioners in the field of diabetes, including best practice recommended approaches and warnings about pitfalls to avoid.
A public health perspective on mitigating the global burden of chronic liver disease
Authors: Maya Balakrishnan, Jürgen Rehm
Journal: Hepatology (2023)

Chronic liver disease is a significant global health problem. Epidemiological trends do not show improvement in chronic liver disease incidence but rather a shift in etiologies, with steatotic liver disease (SLD) from metabolic dysfunction and alcohol becoming increasingly important causes. Consequently, there is a pressing need to develop a comprehensive public health approach for SLD. To that end, we propose a public health framework for preventing and controlling SLD. The framework is anchored on evidence linking physical inactivity, unhealthy dietary patterns, alcohol use, and obesity with both incidence and progression of SLD. Guided by the framework, we review examples of federal/state-level, community-level, and individual-level interventions with the potential to address these determinants of SLD. Ultimately, mitigating SLD’s burden requires primary risk factor reduction at multiple socioecological levels, by scaling up the World Health Organization’s “best buys,” in addition to developing and implementing SLD-specific control interventions.
Regenerative capacity of neural tissue scales with changes in tissue mechanics post injury
Authors: Alejandro Carnicer-Lombarte, Damiano G. Barone, Filip Wronowski, George G. Malliaras, James W. Fawcett, Kristian Franze
Journal: Biomaterials (2023)

Spinal cord injuries have devastating consequences for humans, as mammalian neurons of the central nervous system (CNS) cannot regenerate. In the peripheral nervous system (PNS), however, neurons may regenerate to restore lost function following injury. While mammalian CNS tissue softens after injury, how PNS tissue mechanics changes in response to mechanical trauma is currently poorly understood. Here we characterised mechanical rat nerve tissue properties before and after in vivo crush and transection injuries using atomic force microscopy-based indentation measurements. Unlike CNS tissue, PNS tissue significantly stiffened after both types of tissue damage. This nerve tissue stiffening strongly correlated with an increase in collagen I levels. Schwann cells, which crucially support PNS regeneration, became more motile and proliferative on stiffer substrates in vitro, suggesting that changes in tissue stiffness may play a key role in facilitating or impeding nervous system regeneration.
Alcohol-induced epigenetic changes prevent fibrosis resolution after alcohol cessation in miceresolution
Authors: Michael Schonfeld, Maura O’Neil, Steven A. Weinman, Irina Tikhanovich
Journal: Hepatology (2023)

Background and Aims: Alcohol-associated liver disease is a major cause of alcohol-associated mortality. Recently, we identified hepatic demethylases lysine demethylase (KDM)5B and KDM5C as important epigenetic regulators of alcohol response in the liver. In this study, we aimed to investigate the role of KDM5 demethylases in alcohol-associated liver disease resolution. Approach and Results: We showed that alcohol-induced liver steatosis rapidly resolved after alcohol cessation. In contrast, fibrosis persisted in the liver for up to 8 weeks after the end of alcohol exposure. Defects in fibrosis resolution were in part due to alcohol-induced KDM5B and KDM5C-dependent epigenetic changes in hepatocytes. Using cell-type–specific knockout mice, we found that adeno-associated virus-mediated knockout of KDM5B and KDM5C demethylases in hepatocytes at the time of alcohol withdrawal promoted fibrosis resolution. Single-cell ATAC sequencing analysis showed that during alcohol-associated liver disease resolution epigenetic cell states largely reverted to control conditions. In addition, we found unique epigenetic cell states distinct from both control and alcohol states and identified associated transcriptional regulators, including liver X receptor (LXR) alpha (α). In vitro and in vivo analysis confirmed that knockout of KDM5B and KDM5C demethylases promoted LXRα activity, likely through regulation of oxysterol biosynthesis, and this activity was critical for the fibrosis resolution process. Reduced LXR activity by small molecule inhibitors prevented fibrosis resolution in KDM5-deficient mice. Conclusions: In summary, KDM5B and KDM5C demethylases prevent liver fibrosis resolution after alcohol cessation in part through suppression of LXR activity.
Ironing out kinks in the evidence base
Authors: Rebecca Coombes
Journal: BMJ (2023)

Pity poor Terry Hamblin.In 1981 in The BMJ the haematologist from Bournemouth set out to debunk claims about the iron content of spinach.Years later he realised his work contained a major inaccuracy, and he spent the rest of his life trying to kill the myth.It was too late: an academic urban legend had been born.Nicholas Peoples and colleagues focus on the scourge of
Novel insights into causal effects of serum lipids and lipid-modifying targets on cholelithiasis
Authors: Lanlan Chen, Wei Qiu, Xiaodong Sun, Menghan Gao, Yuexuan Zhao, Mingyue Li, Zhongqi Fan, Guoyue Lv
Journal: Gut (2023)

Objective Different serum lipids and lipid-modifying targets should affect the risk of cholelithiasis differently, however, whether such effects are causal is still controversial and we aimed to answer this question. Design We prospectively estimated the associations of four serum lipids with cholelithiasis in UK Biobank using the Cox proportional hazard model, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Furthermore, we estimated the causal associations of the genetically predicted serum lipids with cholelithiasis in Europeans using the Mendelian randomisation (MR) design. Finally, both drug-target MR and colocalisation analyses were performed to estimate the lipid-modifying targets’ effects on cholelithiasis, including HMGCR , NPC1L1 , PCSK9 , APOB, LDLR, ACLY, ANGPTL3, MTTP, PPARA, PPARD and PPARG . Results We found that serum levels of LDL-C and HDL-C were inversely associated with cholelithiasis risk and such associations were linear. However, the serum level of TC was non-linearly associated with cholelithiasis risk where lower TC was associated with higher risk of cholelithiasis, and the serum TG should be in an inverted ‘U-shaped’ relationship with it. The MR analyses supported that lower TC and higher TG levels were two independent causal risk factors. The drug-target MR analysis suggested that HMGCR inhibition should reduce the risk of cholelithiasis, which was corroborated by colocalisation analysis. Conclusion Lower serum TC can causally increase the risk of cholelithiasis. The cholelithiasis risk would increase with the elevation of serum TG but would decrease when exceeding 2.57 mmol/L. The use of HMGCR inhibitors should prevent its risk.